Republic of the Philippines

City of Iloilo
x-----------------------------------x

AFFIDAVIT OF OBJECTION ON COVID VACCINE

I, _________________________, Filipino citizen, of legal age and a resident

of______________________________________, after having been sworn to in accordance
with the law, depose and say:

1. I object to covid vaccination because the personnel or officers of pharmaceutical

corporations administering the covid vaccine have no liability if it will cause death or injury on
my person. The government should renounce the non-liability of the pharmaceutical
corporations before I agree to covid vaccination;

2. The covid vaccine is experimental and what is required is voluntary and informed
consent. I don’t even know the content and effect of the vaccine and deaths were caused by the
vaccine;

3. It is against my religious belief that my body will be experimented. I am not an animal

and my body is sacred and created by GOD. Nobody can substantially alter my body. This right
is guaranteed by the constitution and the United Nations International Covenant on Civil and
Political Rights; and

4. As of this time there is no law making covid vaccine mandatory.

Affiant SUBSCRIBED AND SWORN to before me this ____day of _________, in the ________,
affiant exhibited to me his/her _______ Identification card with No. __________, said
identification contains the photograph and signature of the affiant.

Witness My Hand and Seal on the date and at the place first above –written.